Template:Epiglottitis Antibiotics
Coverage targets Streptococcus pneumoniae, Staphylococcus pyogenes, and Haemophilus influenzae, and H. parainfluenzae
Immunocompetent
- Ceftriaxone 2gm IV once daily (first line) OR
- Cefotaxime 2gm (50mg/kg) IV three times daily OR
- Ampicillin/Sulbactam 3g (50mg/kg) IV q 6 hours OR
- Levofloxacin 750mg IV once daily
- Consider Vancomycin 15-20mg/kg IV to any of the above if risk of MRSA[1]
Immunocompromised
Coverage should extend to all of the typical organisms above as well as Pseudomonas, M. tuberculosis, and C. albicans
- Cefepime 2g (50/kg) IV q8 hours AND Vancomycin 15mg/kg IV q6 hours
Pediatric Immunocompetent
- Ceftriaxone 50-100mg/kg IV daily (max 2g) (first line) OR
- Cefotaxime 50mg/kg IV q8hrs (max 2g/dose) OR
- Ampicillin/Sulbactam 50mg/kg IV q6hrs (max 3g/dose)
- Consider Vancomycin 15mg/kg IV q6hrs if risk of MRSA
Pediatric Immunocompromised
- Cefepime 50mg/kg IV q8hrs (max 2g) AND Vancomycin 15mg/kg IV q6hrs
- ↑ Young LS, Price CS. Complicated adult epiglottitis due to methicillin-resistant Staphylococcus aureus. Am J Otolaryngol. Nov-Dec 2007;28(6):441-3.